Last Name, First Name, Middle Name:

Email Address:

Street Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Position Applying For:

Location Applying For:
Bartow Davenport 

Are you legally eligiable for employment in the USA?:
Yes No 

Type of Employment:
Full Time Part Time 

Are you 18 years of age or older?:
Yes No 

List any friends or relatives who presently work for Orange Industrial:

Valid Florida Driver’s License is required for all positions you are applying for:

Driver License#:

State:

Class:

Expiration Date:

If you have a Class A or B Driver License, can you operate a “9” or “10” Speed Transmission?
Yes No 

Have you had any accidents in the past three years?
Yes No 

Have you had any moving violations during the past three years?
Yes No 

Have you served in the military?
Yes No 

Have you ever been convicted of a crime, or plead “guilty” to a crime (felony or misdemeanor)?
Yes No 

If yes, explain number of convictions, nature of offenses leading to the convictions, how recent such offense was/where committed, sentence imposed, and types of rehabilitation:

Employment History

May we contact your present employer?
Yes No 

Please list your work experience for the past three years beginning with your most recent job:

Employer #1:

Name of Supervisor:

Address:

City, State, Zip code:

Phone Number:

Dates of Employment (___/___/______ to ___/___/______):

Starting Salary:

Ending Salary:

Reason for Leaving (be specific):

List the jobs that you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

Employer #2:

Name of Supervisor:

Address:

City, State, Zip code:

Phone Number:

Dates of Employment (___/___/______ to ___/___/______):

Starting Salary:

Ending Salary:

Reason for Leaving (be specific):

List the jobs that you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

Employer #3:

Name of Supervisor:

Address:

City, State, Zip code:

Phone Number:

Dates of Employment (___/___/______ to ___/___/______):

Starting Salary:

Ending Salary:

Reason for Leaving (be specific):

List the jobs that you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

Education

Provide the requested information, starting with the most recent attended school:

Type of School #1:

Name of School:

Location:

Number of Years Completed:

Major or Degree:

Type of School #2:

Name of School:

Location:

Number of Years Completed:

Major or Degree:

Type of School #3:

Name of School:

Location:

Number of Years Completed:

Major or Degree:

Type of School #4:

Name of School:

Location:

Number of Years Completed:

Major or Degree:

References

Name:

Address & Phone Number:

Business:

Years Acquainted:

Name:

Address & Phone Number:

Business:

Years Acquainted:

Name:

Address & Phone Number:

Business:

Years Acquainted:

Name:

Address & Phone Number:

Business:

Years Acquainted:

Resume Upload:

In exchange for the consideration of my job application at Orange Industrial Services Inc., I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Orange Industrial Services Inc.

practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Orange Industrial Services Inc., or otherwise to change in any respect to the employment at will relationship between it and the undersigned , and that that the relationship cannot be altered except by written instrument signed by the President/ general Manager of Orange Industrial Services Inc. Both the undersigned and Orange Industrial Services Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that Orange Industrial Services Inc. may unilaterally change or revise their benefits, policies and procedures and such changes may include a reduction in benefits.

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give Orange Industrial Services Inc. permission to contact schools, previous employers (unless otherwise indicated), references, and others and hereby release the Orange Industrial Services Inc. from any liability as a result of such contact.

I also understand that (1) Orange Industrial Services Inc. has a drug and alcohol policy that provides pre-employment testing as well as testing after employment (2) consent to and compliance with such policy is a condition of my employment (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.

I understand that Orange Industrial Services Inc. does not unlawfully discriminate in employment and no questions on this application is used for the purpose of limiting or eliminating any applicant for consideration for employment on any basis prohibited by local, state or federal low.

I further understand that my employment with Orange Industrial Services Inc. shall be probationary for a period of 90 days and further that at any time during the probationary period thereafter, or my employment relation with Orange Industrial Services Inc. is terminable at will for any reason by either party.

This application is current for only (9O) days. At the conclusion of this time, if you have not heard from the company and still wish to be considered for employment it will be necessary for you to complete a new application.

I certify that I have read and fully understand and accept all terms.